Permit CITY OF TIGARD PLUMBING PERMIT
2:. '' COMMUNITY DEVELOPMENT Permit#: PLM2017 00387
Date Issued: 09/27/2017
T-[GAR 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S110AD08700
Jurisdiction: Tigard
Site address: 10700 SW CANTERBURY LN 6
Project: Pacific Crest Apartments Subdivision: None Lot: None
Project Description: (1)clothes washer.
Contractor: THE PLUMBERS INC. Owner: AUK-REDWOOD PC SPE LLC
90 NW 150TH AVE 10695 SW MURDOCK ST
BEAVERTON, OR 97006 TIGARD, OR 97224
PHONE: 503-519-6644 PHONE:
FAX: 503-684-1202
FEES
Quantity Description Date Amount
1 ea Clothes Washer 09/27/2017 $25.02
Specifics: 1 12%State Surcharge- 09/27/2017 $8.70
Plumbing
Type of Use: MF 47 ea Minimum Fee Adjustment- 09/27/2017 $47.48
Class of Work: ALT Plumbing
Type of Const:
Occupancy Grp:
Stories:
Total $81.20
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: � /V moi'Permittee Signature: , /J�/ �-'�,1.l/ ./7//v/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Plumbing Permit Application
Building Fixtures (.,45--7/-7 FOR OFFICE USE ONL`Y,. /�/�
Ri g 17 4 Pe sv /oL4 '_CifJ�
City of Tigard - � � �'a• � ' � PermitNo.: ?/5/�
IN -
q 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review C/
Phone: 503.718.2439 Fax: 503.598.1960Other Permit N..4.1
Date/By: iC 240j?-7,C.407
TIGARD Inspection Line: 503.639.4175 SEP 25 %(k►Ie Ready/By: Juris H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK CITY OF TIGARD FEE* SCHEDULE
❑New construction ❑Demo i i I ,CJI E? For special information use checklist
Total
Description Qty
Eil Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY,OF•CONSTRUCTIOPd SFR(1)bath 312.70
CI1-and 2-family dwelling ❑Commercial/industrial
SFR(2)bath 437.78
SFR(3)bath 500.32
❑Accessory building ligMulti-family Each additional bath/kitchen 25.02
❑Master builder ❑Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION.AND LOCATION Site utilities:
Catch basin or area drain 18.76
Job site address: (blCO ,j vJ C1 '( L--i1/41
Drywell,leach line,or trench drain 18.76
City/State/ZIP: '1-1 C,tW g 7) 8 Q. R-1 ZZ14 Footing drain(no.linear ft.:_) Page 2
Suite/bldg./apt.no.: NO (/ I Project name: 40(p VI/0 .moi 57rK-i Manufactured home utilities 50.03
Cross street/directions to job site: 10 9 `j'TEZE•yr Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:_) Page 2
Storm sewer(no.linear ft.:_) Page 2
Water service(no.linear ft.:_) Page 2
Subdivision: I Lot no.: Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.:
Backwater valve 12.51
DESCRXPTION OF ORK - Clothes washer I 25.02 Z5 C L
JA-t4 L1_ 1,-A4-0/•..)i,ZN BOXDishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
PROPERTY OWNERI `❑
TENANT , Expansion tank 12.51
Fixture/sewer cap
25.02
Name: Nig.- -F.E.Dwoo D PC 'PE Li.-G25.02
Floor drain/floor sink/hub
Address: 10 Gott J 5.,,,4 M U 4174 C l $T 2.E ET Garbage disposal 25.02
City/State/ZIP: -71-1 Gn AiR 9l og C 1 .2-Ly Hose bib 25.02
12.51
Phone:( ) Fax:( ) Ice maker25.02
s APPLICANT ,❑ CONTACT PERSON Interceptor/grease trap
Medical gas(value:$ ) Page 2
Business name: 1.4p5 ..-4,_-11 Primer 12.51
Contact name: (LSE 9e�� 12.51
14 �J Roof drain(commercial)
Address: -PO EoX Z3 tse 1' Sink/basin/lavatory 25.02
City/State/ZIP: --1-1 GA 12-1) 1 p R.. (9Z Z 8 i Solar units(potable water) 62.54
Phone:(Sad 3%1- i 3 Fax: :( )
Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: ‘,,, ,.) L... ccy.VPAI i CO 1M
Water closet 25.02
CONTRACTOR.! Water heater 37.52
Business name: 'T)4 L-'yv%oe 2LS =AC Water piping/DWV 56.29
Address: t3't 00 5v-/ l u e.iv N W^i I S Other: 25.02
Subtotal Z5 '4
City/State/ZIP:•FI ,icR.D i O1`- 112-2.3 Minimum permit fee: $72.50 72 co
Phone:(50 3) 519.. 4.6. '-1 Fax:( )
/ Plan review (25%of permit fee)
CCB Lic.: i'7'Z)Li Plumbing Lie.no.:FRl�j -! 7 State surcharge(12%of permit fee) 8 io
Authorized signature: TOTAL PERMIT FEE " l Zo
This permit application expires if a permit is not obtained within 180 days
Print name' I Date: q,�Z'� I after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I.\ uilding\Permits\PLMU-PermitApp doc 10/01/09 440-4616T(10/02/COM/WEB)
B
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10700 SW CANTERBURY LN 6, TIGARD, November 13, 2017 at
OR, 97224 10:08:32 AM
Record Type: Record ID:
Residential - Plumbing PLM2017-00387
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor